Brain Death Determination and Communication: An Innovative Approach Using Simulation and Standardized Patients.

Context: Palliative medicine clinicians in hospital settings are often involved in the care of patients dying in critical care settings, with a subset from brain death. Brain death is a complex concept, not only for families, but also for clinicians. There is wide variability in adhering to formalized guidelines for brain death determination.

Practice Improvement Projects in an Interdisciplinary Palliative Care Training Program.

Context: Demand for palliative care (PC) continues to increase with an insufficient number of specialists to meet the need. This requires implementation of training curricula to expand the workforce of interdisciplinary clinicians who care for persons with serious illness.

Objectives: To evaluate the impact of utilizing individual practice improvement projects (PIP) as part of a longitudinal PC curriculum, the Coleman Palliative Medicine Training Program (CPMTP-2).

Expanding the Interdisciplinary Palliative Medicine Workforce: A Longitudinal Education and Mentoring Program for Practicing Clinicians.

Context: The disparity between gaps in workforce and availability of palliative care (PC) services is an increasing issue in health care. To meet the demand, team-based PC requires additional educational training for all clinicians caring for persons with serious illness.

Objectives: To describe the educational methodology and evaluation of an existing regional interdisciplinary PC training program that was expanded to include chaplain and social worker trainees.

Training the Workforce: Description of a Longitudinal Interdisciplinary Education and Mentoring Program in Palliative Care.

Context: The rapid increase in demand for palliative care (PC) services has led to concerns regarding workforce shortages and threats to the resiliency of PC teams.

Objectives: To describe the development, implementation, and evaluation of a regional interdisciplinary training program in PC.

Methods: Thirty nurse and physician fellows representing 22 health systems across the Chicago region participated in a two-year PC training program.

Palliative Workforce Development and a Regional Training Program.

Aims: Our primary aims were to assess growth in the local hospital based workforce, changes in the composition of the workforce and use of an interdisciplinary team, and sources of support for palliative medicine teams in hospitals participating in a regional palliative training program in Chicago.

Methods: PC program directors and administrators at 16 sites were sent an electronic survey on institutional and PC program characteristics such as: hospital type, number of beds, PC staffing composition, PC programs offered, start-up years, PC service utilization and sources of financial support for fiscal years 2012 and 2014.

Results: The median number of consultations reported for existing programs in 2012 was 345 (IQR 109 - 2168) compared with 840 (IQR 320 - 4268) in 2014.

When do patient-reported outcome measures inform readmission risk?

Objective: To characterize changes in patient-reported outcome measures from hospital discharge to assess when they best inform risk of utilization as defined by readmissions or emergency department use.

Participants: Patients discharged from an urban safety-net hospital.

Design: Longitudinal cohort study.

Health perceptions and symptom burden in primary care: measuring health using audio computer-assisted self-interviews.

Purpose: To assess the relationships among somatic symptoms and health perception measures in data collected from the implementation of audio computer-assisted self-interview (ACASI) technology in a primary care clinic of a safety-net healthcare system.

Methods: We approached 2,848 English- or Spanish-speaking patients to complete an ACASI-administered survey before their clinic appointment between April 2011 and July 2012. We administered the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health-10 assessing General Self-Rated Health (GSRH), Global Physical and Mental Health; Memorial Symptom Assessment Scale (MSAS) assessing symptom burden; and the Patient Health Questionnaire-2 (PHQ-2).

From Albania to Zambia: travel back to country of origin as a goal of care for terminally ill patients.

Background: With unprecedented levels of international migration, physicians in the United States may care for terminally ill patients who have strong connections to their country of origin and such patients may desire to return in the final stages of life.

Objective: In this study, we analyzed how often terminally ill patients cited travel to country of origin as a goal of care, how often travel occurred, and factors associated with successful travel.

Design: A retrospective chart review from January 1, 2005 through May 1, 2007.